Clinical Efficacy of Incomplete Cognitive Behavior Therapy for
Insomnia

J Korean Neurol Assoc > Volume 32(3); 2014 > Article

Journal of the Korean Neurological Association 2014;32(3): 150-157.

치료세션을 마치지 않은 환자들에서 불면증인지행동치료의 효과

최수정, 주은연 a,b 홍승봉 a,b

성균관대학교 의과대학 삼성서울병원 뇌신경센터 , 신경과학교실

Clinical Efficacy of Incomplete Cognitive Behavior Therapy for Insomnia

Su Jung Choi

Brain-Nerve Center and Department of Neurology , Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Abstract

Background: It is widely accepted that cognitive-behavioral therapy for insomnia (CBT-I) is more effective than pharmacological treatments. However, the lack of trained experts and the duration, intensity, and cost of four individual treatment sessions curtail the widespread use of CBT-I in Korea. The aim of this study was to determine the clinical efficacy in patients who completed four sessions of CBT-I and in those who did not.
Methods: We investigated 81 patients with chronic insomnia (32-82 years old) who participated individual, four-session CBT-I between February 2010 and June 2013. The clinical efficacy was evaluated by estimating of total sleep time (TST), sleep latency (SL), waking after sleep onset (WASO), and sleep efficiency (SE) based on the sleep diaries.
Results: Of the 81 patients, 28 (34.6%) completed the four sessions. 22 (27.1%) withdrew after 1 st session, 17 (20.9%) dropped after 2 nd session, and 8 (9.9%) stopped voluntarily after 3 rd session. Six were excluded due to incomplete sleep diaries. Clinical efficacy was measured in patients who completed at least two sessions (n=53, 65.4%); the mean SE improved from 68.8 to 87.6%, and in 40 (75.4%) the SE was normalized (≥85%). Other parameters (TST, from 321.0 to 351.3 min; SL, from 61.9 to 25.0 min; WASO, from 86.3 to 24.4 min) were all improved after incomplete CBT-I.
Conclusions: Sleep induction and maintenance as well as quality have improved in patients who underwent at least two of the four CBT-I sessions. It needs to develop briefer CBT-I to increase adherence to patients. Key Words: Insomnia, Behavior therapy, Sleep